Individual
DR. JASON HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2000 S 900 E, SALT LAKE CITY, UT 84105-3208
(801) 466-6647
(801) 464-7558
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 466-6647
(801) 464-7558
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2007-00601
NC
207N00000X
Dermatology Physician
Primary
364336-1205
UT
207ND0101X
MOHS-Micrographic Surgery Physician
2007-00601
NC
207ND0900X
Dermatopathology Physician
2007-00601
NC
207NS0135X
Procedural Dermatology Physician
2007-00601
NC
Other
Enumeration date
09/24/2006
Last updated
06/09/2011
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